Enrollment Representative (Onsite)

The job overview for this position is that the Enrollment Representatives are responsible for facilitating the processing, coordination, and handling of all Medicare enrollment and disenrollment functions. They work closely with internal departments and CMS to ensure timely and accurate processing. The role also involves providing general assistance to the Member Services Department. The position is based in the Anaheim office and requires working Monday to Friday from 7am to 4pm, with some overtime required.

• Handle and process all member enrollment, disenrollment, and cancellation requests
• PDF all incoming applications and disenrollments from email Inbox fax or electronic enrollment
• Verify and print beneficiary eligibility evidence for Part A/B, Medi-cal and Wipro
• Date stamp, sort and combine application with eligibility into PDF packets
• Screen all incoming application and follow up with broker for all discrepancies / missing information
• Key application into Enrollment system for tracking and confirmation purposes
• Process enrollment applications: Data entry of prospective member into enrollment system
• Generate submission report and upload enrollment application to member profile on a daily basis
• Print auto-generated notices and mail out
• Verification of member with Medi-Cal eligibility through online verification
• Notify Broker Relations Department when questionable or non-compliant pattern is identified with specific brokers
• Outbound calls to members for research or obtaining additional information
• Participating in Team chats, emails and meetings related to Department operations
• Conduct any necessary research on questionable applications
• Coordinate with Marketing Department to properly track the mailing of ID cards and other applicable letter/notices to members
• May receive transferred calls from Member Services Department and/or other departments
• Assist in translation and proofreading upon request from upper management and the marketing department
• Follow defined work schedule and handle outbound customer calls and assignments in a professional manner
• Must follow company and department guidelines for all time off/vacation/overtime requests
• Work on assigned/required weekends and after hours during open enrollment season
• Previous experience in customer service
• Strong communication skills, both verbal and written
• Must be detailed oriented and present critical analytical thinking skills
• Must display active listening skills and empathy towards customers.

• High School diploma or GED required
• One (1) to three (3) years of health plan or clerical experience required
• Previous knowledge and/or experience working with Managed Care, and/or Medicare Advantage required
• Bilingual in Spanish preferred
• Previous experience in customer service
• Strong communication skills, both verbal and written (bilingual is a plus, but not required)
• Must be detailed oriented and present critical analytical thinking skills
• Must display active listening skills
• Ability to handle outbound customer calls and assignments in a professional manner
• Must follow company and department guidelines for all time off/vacation/overtime requests, especially during enrollment season
• Willingness to work on assigned/required weekends and after hours during open enrollment season

• Health benefits
• Life and disability benefits
• 401(k) savings plan with match
• Up to 21 days of PTO
• 10 paid holidays, plus 2 floating holidays per year
• Lifestyle spending account